Enter and view: Dementia care in Community Hospitals

Healthwatch Gloucestershire undertook a series of enter and view visits to 7 community hospitals observe and report upon the care of patients living with dementia during the period 28 January to 3 March 2016.

The effort made across many of the community hospitals to take the needs of dementia patients into account in the decoration of the wards contributed to the overall impression of them being friendly and welcoming. These included the use of colour to identify specific areas, dementia-friendly signs and clocks, as well as noticeboards with information about dementia which were observed in a few of the hospitals. Three hospitals have set up ‘vintage rooms’ and although these changes are not yet universal, it is seen as a positive move for patients and their families.

Representatives observed equipment in the corridors of two Cirencester Hospital wards which caused difficulties for a patient with a Zimmer frame. It is suggested that staff need to be aware of potential obstructions for patients, particularly for those with mobility issues or dementia.

Dementia specialist staff work at five of the hospitals, and there is a role in development at Vale Community Hospital. It is unclear whether there is a specialist role at Lydney & District Hospital, although there is a relationship with the Dementia Leads at The Dilke Memorial Hospital. The reported numbers of staff across all community hospitals who have attended the two-day dementia training course is very encouraging. 

Following the principles set out in John’s Campaign, most of Gloucestershire’s community hospitals are flexible over visiting times for families and carers. 

Although there were limited opportunities for Representatives to discuss the hospitals with families and carers, views gathered indicate that the treatment of patients and their visitors was regarded positively. Staff comments also indicate a recognition that the families and carers of patients are part of the team and that their own needs, whether to continue to care for the patient or to have respite from caring responsibilities, should be recognised.

There appears to be good awareness of support options for meals for people with dementia. The red tray system is in operation in all of the community hospitals to varying degrees, allowing for the monitoring and provision of support to patients who may need assistance.

Coloured crockery was seen in some hospitals and not others, although Representatives were told it was available if needed. Coloured cutlery seems to be less well used, although all hospitals indicate it is available. The visits all included lunchtime, apart from Tewkesbury Community Hospital, and there were patients living with dementia in every hospital. It may have been determined that coloured crockery was not required, or Representatives did not witness its use if the patient was in a single room.

The way that staff make use of the information in the booklet can help personalise the care provided for a patient with dementia enormously. 

Currently Cirencester Hospital, Tewkesbury Community Hospital, and Vale Community Hospital have facilities to enable family members or carers to stay overnight with the patient, in line with the principles of John’s Campaign.

In addition to welcoming families and carers to support patients at mealtimes, Cirencester Hospital, The Dilke Memorial Hospital, and North Cotswold Hospital will also offer the visiting carer a meal, on a case by case basis. The Dilke Memorial Hospital will set up a table and provide a meal for a visiting spouse, where it has been found to be easier for the spouse to eat with the patient, and North Cotswold Hospital staff encourage communal dining with relatives in the large day room.